Femto Laser-Assisted Sutureless Lamellar Keratoplasty for Anterior Stromal Pathologies Including Recurrent Anterior Corneal Dystrophies
Narrative Responses:
Purpose
To report the long-term visual and refractive outcomes and complications of Femtosecond laser assisted sutureless Anterior Lamellar Keratoplasty (FALK) for anterior stromal corneal pathologies including recurrent anterior corneal dystrophies.
Methods
Fouteen eyes of 14 patients with varying pathologies in the anterior 250 microns of corneal stroma underwent FALK procedure using femtosecond laser. This incuded seven eyes that had earlier undergone multiple procedures like PTK, DALK and PK. Parameters noted included indication for surgery, logMAR visual acuity, pachymetry, duration of follow up, refraction at last follow up as well as complications were noted. The Wilcoxon signed rank test was used to analyse difference in logMAR visual acuity before and after surgery.
Results
Indications for FALK included Anterior granular corneal dystrophy (3 eyes), Reisbuckler's dystrophy (3 eyes), gelatinous droplike keratopathy,GDLK (3 eyes), spheroidal degeneration (2 eyes) and anterior stromal corneal scar with intrastromal glass foreign body (1 eye) and corneal scars (2 eyes). Anterior lamellar donor corneal tissue was successfully integrated into the host bed without need for sutures in all 14 eyes. Mean duration of follow up was 14.2 months. Uncorrected logMAR visual acuity improved significantly from a mean of 1.92 to 0.9,following FALK (p<0.05). No significant intraoperative or postoperative complications were noted other than a partially displaced lenticle in one eye.
Conclusion
FALK appears to be a safe and effective procedure for anterior stromal corneal pathologies, providing excellent improvement in visual acuity without the need for sutures or tissue ablation. This can also be considered as an excellent option for recurrent anterior corneal dystrophies having earlier undergone various corneal surgeries.